NPI | 1659898948 |
---|---|
Former Name | SHELBY DIANE GREEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 132240) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2017-08-28 |
Last Update Date | 2023-01-09 |